Laparoscopic surgery is a modern surgical technique performed through small incisions, which involves the visualisation of body cavities using telescopes with attached camera systems. Trocars or cannulae are inserted through the incisions to facilitate the smooth passage of telescopes and slender long instruments into these cavities. A fundamental feature of laparoscopic surgery is the use of a laparoscope: a telescopic rod lens system that is usually connected to a visual acquisition device, such as a camera. Most typically, a fibre optic cable system connected to a ‘cold’ light source such as halogen or xenon is used to illuminate the operative field. The internal appearances of the body cavities are visualised on visual display monitors. The monitor image is 2-dimensional, and the movement of the instruments is seen in parallax. These combined features mean that surgeons training in this field of surgery not only have to learn individual surgical procedures, they must also become comfortable working in a 3-dimensional environment which has been translated to a 2-dimensional output.
The restricted vision, the difficulty in handling of the instruments, the acquisition of new hand-eye coordination skills, the lack of tactile perception and the limited working area are factors which add to the technical complexity of this surgical approach. For these reasons, minimally invasive surgery has emerged as a highly competitive new sub-specialty within various fields of surgery. Surgical residents, who wish to focus on this area of surgery, gain additional training during one or two years of fellowship after completing their basic surgical residency. Accordingly, the use of a simulator allows the trainee surgeon not only to learn the skills that when eventually combined, become a procedure, but they can also experience the unique appreciation of 2-dimensional visualisation of the 3-dimensional surgical field.
A simulator replicating the laparoscopic environment as experienced in an operating theatre, is superior to other inanimate simulators. Any learned procedure is a combination of several different skills, in other words all procedures can be broken down into individual component skills. These skills include the ability to correctly orientate a camera, manipulate objects in 3 dimensions, cut tissue, and suture (stitch). The simulator facilitates the trainee in attaining proficiency at these tasks prior to actually entering the operating room environment.
Once a surgical trainee or surgeon acquires a skills set, they can then move on to performing a variety of surgical procedures. It is estimated that individual skills have to be repeated up to 30 times before a surgeon is considered proficient. This also applies to entire procedures. A simulator can also help simulate an entire procedure, where the skills are combined on a suitable model, again without endangering a patient. For example a laparoscopic cholecystectomy (removal of a gall bladder), the most common laparoscopic procedure performed, is a combination of grasping, dissection, clipping and cutting. All these skills can be simulated and indeed the procedure itself can then be performed on a simple model.
It is an object of the present invention to provide a laparoscopic apparatus for the training of medical professionals, particularly those engaged in the field of laparoscopic surgery. In particular, it is envisaged that the present invention will provide a realistic surgical experience by mimicking the sensation of carrying out surgical techniques on a patient.